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From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies

Normothermic Regional Perfusion (NRP) has shown encouraging clinical results. However, translation from an experimental to routine procedure poses several challenges. Herein we describe a model that led to the implementation of NRP into standard clinical practice in our centre following an iterative...

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Autores principales: Hunt, Fiona, Johnston, Chris J. C., Coutts, Lesley, Sherif, Ahmed E., Farwell, Lynsey, Stutchfield, Ben M., Sewpaul, Avi, Sutherland, Andrew, Babu, Benoy I., Currie, Ian S., Oniscu, Gabriel C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9203686/
https://www.ncbi.nlm.nih.gov/pubmed/35721469
http://dx.doi.org/10.3389/ti.2022.10493
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author Hunt, Fiona
Johnston, Chris J. C.
Coutts, Lesley
Sherif, Ahmed E.
Farwell, Lynsey
Stutchfield, Ben M.
Sewpaul, Avi
Sutherland, Andrew
Babu, Benoy I.
Currie, Ian S.
Oniscu, Gabriel C.
author_facet Hunt, Fiona
Johnston, Chris J. C.
Coutts, Lesley
Sherif, Ahmed E.
Farwell, Lynsey
Stutchfield, Ben M.
Sewpaul, Avi
Sutherland, Andrew
Babu, Benoy I.
Currie, Ian S.
Oniscu, Gabriel C.
author_sort Hunt, Fiona
collection PubMed
description Normothermic Regional Perfusion (NRP) has shown encouraging clinical results. However, translation from an experimental to routine procedure poses several challenges. Herein we describe a model that led to the implementation of NRP into standard clinical practice in our centre following an iterative process of refinement incorporating training, staffing and operative techniques. Using this approach we achieved a four-fold increase in trained surgical staff and a 6-fold increase in competent senior organ preservation practitioners in 12 months, covering 93% of the retrieval calls. We now routinely provide NRP throughout the UK and attended 186 NRP retrievals from which 225 kidneys, 26 pancreases and 61 livers have been transplanted, including 5 that were initially declined by all UK transplant centres. The 61 DCD(NRP) liver transplants undertaken exhibited no primary non-function or ischaemic cholangiopathy with up to 8 years of follow-up. This approach also enabled successful implementation of ex situ normothermic liver perfusion which together with NRP contributed 37.5% of liver transplant activity in 2021. Perfusion technologies (in situ and ex situ) are now supported by a team of Advanced Perfusion and Organ Preservation Specialists. The introduction of novel perfusion technologies into routine clinical practice presents significant challenges but can be greatly facilitated by developing a specific role of Advanced Perfusion and Organ Preservation Specialist supported by a robust education, training and recruitment programme.
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spelling pubmed-92036862022-06-18 From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies Hunt, Fiona Johnston, Chris J. C. Coutts, Lesley Sherif, Ahmed E. Farwell, Lynsey Stutchfield, Ben M. Sewpaul, Avi Sutherland, Andrew Babu, Benoy I. Currie, Ian S. Oniscu, Gabriel C. Transpl Int Health Archive Normothermic Regional Perfusion (NRP) has shown encouraging clinical results. However, translation from an experimental to routine procedure poses several challenges. Herein we describe a model that led to the implementation of NRP into standard clinical practice in our centre following an iterative process of refinement incorporating training, staffing and operative techniques. Using this approach we achieved a four-fold increase in trained surgical staff and a 6-fold increase in competent senior organ preservation practitioners in 12 months, covering 93% of the retrieval calls. We now routinely provide NRP throughout the UK and attended 186 NRP retrievals from which 225 kidneys, 26 pancreases and 61 livers have been transplanted, including 5 that were initially declined by all UK transplant centres. The 61 DCD(NRP) liver transplants undertaken exhibited no primary non-function or ischaemic cholangiopathy with up to 8 years of follow-up. This approach also enabled successful implementation of ex situ normothermic liver perfusion which together with NRP contributed 37.5% of liver transplant activity in 2021. Perfusion technologies (in situ and ex situ) are now supported by a team of Advanced Perfusion and Organ Preservation Specialists. The introduction of novel perfusion technologies into routine clinical practice presents significant challenges but can be greatly facilitated by developing a specific role of Advanced Perfusion and Organ Preservation Specialist supported by a robust education, training and recruitment programme. Frontiers Media S.A. 2022-06-03 /pmc/articles/PMC9203686/ /pubmed/35721469 http://dx.doi.org/10.3389/ti.2022.10493 Text en Copyright © 2022 Hunt, Johnston, Coutts, Sherif, Farwell, Stutchfield, Sewpaul, Sutherland, Babu, Currie and Oniscu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Hunt, Fiona
Johnston, Chris J. C.
Coutts, Lesley
Sherif, Ahmed E.
Farwell, Lynsey
Stutchfield, Ben M.
Sewpaul, Avi
Sutherland, Andrew
Babu, Benoy I.
Currie, Ian S.
Oniscu, Gabriel C.
From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies
title From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies
title_full From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies
title_fullStr From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies
title_full_unstemmed From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies
title_short From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies
title_sort from haphazard to a sustainable normothermic regional perfusion service: a blueprint for the introduction of novel perfusion technologies
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9203686/
https://www.ncbi.nlm.nih.gov/pubmed/35721469
http://dx.doi.org/10.3389/ti.2022.10493
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